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Benefits 2012/2013 - - An HR Liaison Presentation. June 2012. Ellen Gerescher. Employee Benefits Manager A&M System Office. Contract Renewals. The System Benefits Office administers the System benefit plans and has fiduciary responsibility for sound management of the premium resources

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Benefits 2012/2013 - - An HR Liaison Presentation

  • June 2012

Ellen Gerescher

Employee Benefits Manager A&M System Office

Contract renewals
Contract Renewals

  • The System Benefits Office administers the System benefit plans and has fiduciary responsibility for sound management of the premium resources

  • Renewed contracts with both BlueCross BlueShield and Medco will result in significant savings

    • Lower administrative fees, greater network discount savings

Benefit changes for 9 1 12
Benefit Changes for 9-1-12

Tobacco User Additional Premium

Consolidation of Health plans

Dependent Audit

What constitutes a tobacco user
What constitutes a tobacco user?

This can be defined many different ways.  The A&M System will follow the standard used by the ERS in order to be consistent with other State entities.  A tobacco user is someone who has utilized tobacco more than five times in the previous three months.

Two years of changes
Two Years of Changes

  • Changes for 2011-12

    • Merged two A&M Care plans into one plan

  • Changes for 2012-13

    • Merging the Scott & White Health Plan into the A&M Care Plan

Behind the consolidation
Behind the Consolidation

  • Larger, single risk pool eliminates selection bias and adverse selection

    • SWHP enrollment has decreased over the past several years

    • Costs have increased

      • Members aged

      • Costs for doctors outside the clinic increased

    • Plan design continued to mirror that of the A&M Care plan

Transitioning from scott white
Transitioning from Scott & White

  • While plan choice may be gone ---- physician choice remains

  • Decrease in monthly premiums

  • Virtually all S&W doctors are in the BlueCross BlueShield network

    • BCBS phone number for Scott & White members with questions: 1-866-231-5581

Transitioning cont
Transitioning (cont.)

  • The Scott & White pharmacies are in the Medco network

  • Medco website for information about coverage for specific drugs:

New for the a m care plan
New for the A&M Care Plan

Starting August 1, your A&M UIN will be your BlueCross BlueShield ID Number, beginning with TXW (for employees) and ZGB (for retirees) – all existing members will get new ID cards

Benefits Value Advisor – service that helps employees by locating providers, providing cost estimates, scheduling procedures, etc.

New for the grad plan
New for the Grad Plan

  • Expanded to be compliant with Federal Healthcare reform

    • No plan-year maximum for drug coverage

    • Preventive care provided at 100%

    • No pre-existing coverage limitation for members under age 19

Dependent audit
Dependent Audit

Approximately 10,000 employees with dependent medical coverage audited

Approximately 750 dependents dropped; however many dropped voluntarily

Audit continues for those with dependents on dental, vision and dependent life only

Thank You!

Ellen Gerescher

System Benefits Administration

[email protected]